The importance of patient safety in medicine and dentistry cannot be understated. Wrong tooth extractions account for approximately 25% of wrong-site surgery, and the implications for the patient, the team, and the institution can be profound. The development of national safety standards for invasive procedures (NatSSIPs) has led to the introduction of specialty-specific local safety standards for invasive procedures (LocSSIPs), with the aim of improving safety further. The implementation of outpatient LocSSIPs is recommended in clinical dentistry when surgical interventions regularly take place. We have implemented an outpatient LocSSIPs checklist for all procedures done under local anaesthesia in the oral and maxillofacial surgical unit of a large district general hospital. Feedback from a staff survey six months after its introduction was positive from both clinicians and nursing staff. Since its implementation 18 months ago no serious incidents have been reported and staff think that safety has improved. The reporting of incidents, for example, missing clinical notes and faulty equipment, has become more common (showing better awareness) and the development of a team-led approach has improved the running of the department. PURPOSE Carpal malalignment following intra-articular fractures has been reported in the literature, with no clear description of possible ligamentous injury leading to the radiological appearance. This study presents a series of patients that developed carpal instability nondissociative (CIND) following acute wrist fractures. The mechanism of injury is postulated by using a cadaveric laboratory investigation. METHOD Twelve patients with average age of 32 years were identified with CIND, between 2013 and 2018. Ten patients with a normal carpal alignment in the initial postoperative radiographs exhibited CIND-palmar radiographically at different postoperative periods, and 2 patients showed CIND-dorsal in the initial postoperative x-rays. Four cadaveric specimens were used to validate this injury pattern. RESULTS In cadaveric dissections, CIND-palmar could be reproduced by applying an axial loading and dorsal shearing force on a wrist with sequential sectioning of dorsal and palmar extrinsic wrist ligaments. Fon by capsular repair, whereas cases with fixed deformity and residual joint incongruity may be best managed with a limited radiocarpal arthrodesis. TYPE OF STUDY/LEVEL OF EVIDENCE Diagnostic IV. PURPOSE Miniplates were initially developed as targets for foot and hand fractures, but they have been used in the treatment of fixation of small bone fragments, reduction of long bone fractures and non-union treatment, which have been difficult to treat. In this study, the authors used miniplates to treat fractures of the upper extremities, lower extremities, and pelvis obtained good outcomes. Herein, the authors report these good outcomes and review the current concept of miniplates. https://www.selleckchem.com/products/unc6852.html PATIENTS AND METHODS Forty-two patients treated with miniplates between March 2012 and March 2017 who attended follow-up for &gt;&nbsp;1 year were included in this retrospective study. Miniplates were selected according to purpose, which was classified into three categories fixation, reduction, and stability enhancement. For fixation, miniplates were used to fix distal fibular fractures occurring distal to the syndesmosis and treat patellar and olecranon fractures with severe comminution. For reduction, miniplates were used to reduce tfixation force for nonunion treatment. BACKGROUND To date, limited evidence exists regarding follow-up imaging during the non-operative management (NOM) of blunt splenic injury (BSI), especially concerning ultrasound as first-line imaging modality. The aim of this study was to investigate the incidence and time to failure of NOM as well as to evaluate the relevance of follow-up imaging. METHODS All adult patients with BSI admitted to our level I trauma center, including two associated hospitals, between 01/01/2010 and 31/12/2017 were retrospectively analyzed. Demographic data, comorbidities, injury pattern, trauma mechanism, Injury Severity Score, splenic injury grade and free intra-abdominal fluid were reviewed. Additional analysis of indication, frequency, modality, results and consequences of follow-up imaging was performed. Risk factors for failure of NOM were evaluated using fisher's exact test. RESULTS A total of 122 patients with a mean age of 43.8&nbsp;±&nbsp;20.7 years (16-84 years) met inclusion criteria. Twenty patients (16.4%) underwent immediatte that a routine follow-up imaging, regardless of the modality, has limited therapeutic advantage. Indication for radiological follow-up should be based on clinical findings. If indicated, a CT scan should be used as preferred imaging modality. Fractures in poliomyelitic limbs are a challenge to surgeons, due to polio's sequelae and morphological disorders, which make conventional osteosynthesis difficult. We present a retrospective study of 62 patients and 73 non-simultaneous fractures in their lower limbs. Average age was 61,7 years and 53,2% were females. We analyzed the preinjury functional level, etiology of the fracture, fracture pattern, treatment used (be conservative or surgical), and implant used in surgical cases. We treated 85,1% of them surgically and 37,9% of them maintained the same functional situation as before the fracture. 55,4% of them experienced the need to add some mechanical aids after the lesion and 6,8% lost the ability to walk. Most of the surgical treatments employed were similar as the ones used in non-poliomyelitic patients, although some cases required atypical implants, such as a Multiloc (® DePuy Synthes) humeral nail for a tibial shaft fracture, due to narrow bone. Mortality along the 1st year was 2.7%. We found similar functional and radiological results as those described in non-poliomyelitic limbs. OBJECTIVE The aim was to study vocal tract dimensions in four vocal modes - Neutral, Curbing, Overdrive and Edge - from Complete Vocal Technique (CVT) by means of magnetic resonance imaging (MRI). Furthermore, the purpose was to test the feasibility of MRI to assess CVT vocal modes. METHODS Four nonclassical singers (two females, two males) trained in CVT were imaged with an MRI scanner while singing sustained vowels at same pitch (Bb4 for females, F4 for males) in all vocal modes. Audio signals were simultaneously recorded through a pipe for quality assurance purposes. Auditory evaluation was performed by three CVT teachers in the scanner control room via headphones, and by one CVT teacher inside the MRI room. Previously developed measurement models modified by the authors were used to measure vocal tract dimensions from sagittal MRI projections. Repeatability test was performed for all measurements. RESULTS In all subjects, vocal tract dimensions displayed differences between the vocal modes. Edge stood out from other vocal modes by showing most laryngeal narrowing accompanied by shortest vocal tract and highest vertical laryngeal position.